Stangeland Tormod, Hanssen-Bauer Ketil, Siqveland Johan
Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Int J Ment Health Syst. 2025 Jan 30;19(1):5. doi: 10.1186/s13033-025-00662-0.
Health personnel lack a common standard for assessing lethality of suicide attempts. This may lead to inconsistent assessments and unclear reports about suicide attempts. We argue that the Risk-Rescue Rating Scale (RRRS) may help in resolving this problem. It is a measure based on observable indications of the medical danger of a suicide attempt and of the patient's efforts to avoid or achieve rescue. The instrument is a clinician-rated supplement to self-reports and can be administered in a few minutes and learned in a single brief teaching session. We adapted the RRRS for contemporary use in a Norwegian acute adolescent mental health service clinic. We developed a training program for clinicians, a user manual, and a series of five video-based role-played interview cases for reliability testing. In this study, we recruited 28 clinicians with professional backgrounds typical of Norwegian mental health personnel. They rated five role-played video interviews using the RRRS and the well-established interview instrument the Suicide Intent Scale (SIS) and obtained 140 sets of scores. We estimated the interrater reliability (intraclass correlation coefficient [ICC]) to be .93 for the RRRS and .94 for the SIS, both excellent levels. Correlation was .80 between the RRRS and SIS items that were similar to the RRRS and .53 for SIS items measuring other topics, indicating good concurrent and discriminant validity. Adopting a common standard for communicating about suicide attempts can improve clinical practice, and the RRRS may prove to be a reliable and practical candidate for this task.
卫生人员缺乏评估自杀未遂致死性的通用标准。这可能导致对自杀未遂的评估不一致以及报告不明确。我们认为，风险-救援评级量表（RRRS）可能有助于解决这一问题。它是一种基于自杀未遂的医疗危险以及患者避免或寻求救援努力的可观察迹象的测量方法。该工具是对自我报告的临床医生评级补充，可在几分钟内完成，只需简短的一次教学课程就能学会。我们对RRRS进行了改编，以便在挪威青少年急性心理健康服务诊所中当代使用。我们为临床医生制定了培训计划、用户手册以及一系列五个基于视频的角色扮演访谈案例用于信度测试。在本研究中，我们招募了28名具有挪威心理健康人员典型专业背景的临床医生。他们使用RRRS和成熟的访谈工具自杀意图量表（SIS）对五个角色扮演视频访谈进行评级，共获得140组分数。我们估计RRRS的评分者间信度（组内相关系数[ICC]）为0.93，SIS为0.94，两者均为优秀水平。RRRS与SIS中与RRRS类似的项目之间的相关性为0.80，SIS中测量其他主题的项目相关性为0.53，表明具有良好的同时效度和区分效度。采用关于自杀未遂沟通的通用标准可以改善临床实践，RRRS可能被证明是这项任务的可靠且实用的候选工具。
